Provider Demographics
NPI:1114330842
Name:GONZALEZ MALDONADO, CYNTHIA (MD)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:GONZALEZ MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:GONZALEZ MALDONADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:GPO BOX 364708
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4708
Mailing Address - Country:US
Mailing Address - Phone:787-758-8383
Mailing Address - Fax:787-763-9758
Practice Address - Street 1:SERGIO CUEVAS BUSTAMANTE STREET #550
Practice Address - Street 2:AVE DOMENECH
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-8383
Practice Address - Fax:787-763-9758
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21263208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice